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Introduction <p>Effective cardiovascular (CV) prevention requires accurate risk estimation and patient engagement, which depends on perceived risk. The Perception of Risk of Heart Disease Scale (PRHDS) is a validated tool, yet clinical thresholds for its brief Italian version are lacking.</p> Aim <p>To provide further validation of the Brief Italian version of the PRHDS (PRHDS-BI) in a new cohort, examining convergent and divergent validity, and to establish clinical thresholds and a discrepancy index comparing perceived risk with objective estimates.</p> Methods <p>285 adults (40–69 years) were involved in this multicentre cross-sectional study (NCT06190743). Participants were without a history of CV disease and completed the PRHDS-BI and the Patient Health Questionnaire-4 (PHQ-4). CV real risk was estimated using the Systematic Coronary Risk Evaluation 2 (SCORE2). Confirmatory Factor Analysis (CFA), correlation analyses, and cut-off definitions were used to validate the scale and analyze risk discrepancies.</p> Results <p>The PRHDS-BI showed good internal consistency and strong convergent validity. Clinical thresholds were defined by percentiles: scores 6–12 (low/moderate), 13–17 (high), and 18–24 (very high). A significant mismatch emerged: 63.5% of participants at low/moderate actual risk overestimated their risk, while 80% at very high actual risk underestimated it. This perception–reality gap was statistically confirmed.</p> Conclusions <p>The PRHDS-BI is a valid tool for assessing CV risk perception. Establishing thresholds allows for tailored risk communication and patient-centered interventions, particularly by nursing professionals in primary prevention settings.</p>

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Validation of Risk Perception Cut-Offs in Italian Brief PRHDS (PRHDS-BI): Implications for Primary Cardiovascular Prevention

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • Rosa Debora,
  • Adorni Roberta,
  • Trenta Alessia,
  • D’Andrea Miriana,
  • Alberti Mariangela,
  • Gianfranceschi Enrico,
  • Di Matteo Roberta,
  • Steca Patrizia,
  • Maconi Antonio,
  • Manara Duilio Fiorenzo,
  • Faini Andrea,
  • Simonelli Niccolò,
  • Concetta Leotta,
  • Gianfranco Pistis,
  • Mariasilvia Como,
  • Werba José Pablo,
  • Tatiana Bolgeo,
  • Claudio Bassi,
  • Elisa Nardin,
  • Elisabetta Bagnato,
  • Carla Amigoni,
  • Giulia Villa,
  • Oronzo Chialà

摘要

Introduction

Effective cardiovascular (CV) prevention requires accurate risk estimation and patient engagement, which depends on perceived risk. The Perception of Risk of Heart Disease Scale (PRHDS) is a validated tool, yet clinical thresholds for its brief Italian version are lacking.

Aim

To provide further validation of the Brief Italian version of the PRHDS (PRHDS-BI) in a new cohort, examining convergent and divergent validity, and to establish clinical thresholds and a discrepancy index comparing perceived risk with objective estimates.

Methods

285 adults (40–69 years) were involved in this multicentre cross-sectional study (NCT06190743). Participants were without a history of CV disease and completed the PRHDS-BI and the Patient Health Questionnaire-4 (PHQ-4). CV real risk was estimated using the Systematic Coronary Risk Evaluation 2 (SCORE2). Confirmatory Factor Analysis (CFA), correlation analyses, and cut-off definitions were used to validate the scale and analyze risk discrepancies.

Results

The PRHDS-BI showed good internal consistency and strong convergent validity. Clinical thresholds were defined by percentiles: scores 6–12 (low/moderate), 13–17 (high), and 18–24 (very high). A significant mismatch emerged: 63.5% of participants at low/moderate actual risk overestimated their risk, while 80% at very high actual risk underestimated it. This perception–reality gap was statistically confirmed.

Conclusions

The PRHDS-BI is a valid tool for assessing CV risk perception. Establishing thresholds allows for tailored risk communication and patient-centered interventions, particularly by nursing professionals in primary prevention settings.